Management of low back pain in primary care prior to multidisciplinary functional restoration: a retrospective study of 72 patients.
OBJECTIVE
Chronic low back pain is a major socioeconomic health issue, due to the high direct (healthcare) and indirect (sick leave) costs. The aim of the present study was to describe the primary care management of low back pain patients prior to their inclusion in a multidisciplinary functional restoration network.


METHODS
A descriptive, retrospective, questionnaire-based survey of the general practitioners dealing with 72 low back pain patients.


RESULTS
Patients had been monitored by their general practitioner for an average of four years, with a mean frequency of eight appointments per year per patient. Ninety-three percent and 60% of the patients had been referred to a rheumatologist and a surgeon, respectively. Ninety-eight percent had had lumbar radiographies, 80% had undergone a computed tomography scan and 64% had undergone magnetic resonance imaging. The most commonly prescribed medications were anti-inflammatories and first- or second-line analgesics. Thirty percent had already received morphine analgesics and 50% had taken antidepressants. Thirty-two percent had undergone lumbar surgery. Physiotherapy was frequently reported and, indeed, 6% of patients had participated in over 100 sessions. Total sick leave averaged 8.25 months over the study's follow-up period.


CONCLUSIONS
The time interval before referral to a multidisciplinary care team is long and so GPs should be encouraged and helped to organize this process earlier. It is also essential to determine factors which predict progression to chronic LBP.
Bouton
C
C
Laboratoire d'ergonomie, epidémiologie et santé au travail, faculté de médicine, université d'Angers, rue Haute-de-Reculée, 49045 Angers cedex, France.
Roche
G
G
Roquelaure
Y
Y
Legrand
E
E
Penneau-Fontbonne
D
D
Dubus
V
V
Bontoux
L
L
Huez
J-F
JF
Rucay
P
P
Parot-Shinkel
E
E
Fanello
S
S
Richard
I
I
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000191:economics / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D018710:Pain Clinics / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011859:Radiography; D020127:Recovery of Function; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D000928:Antidepressive Agents